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General NPI Number Information
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NPI Number | 1174259592
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Entity Type | Individual
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Provider Name | MANUEL MORAN JR. NP
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Gender | Male
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Dates
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Enumeration Date | 07/27/2022
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 2051 MARENGO ST
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City | LOS ANGELES
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State | CA
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Zip | 90033-1352
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Country | US
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Telephone | 323-409-3577
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Fax | 323-226-8340
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Provider Business Mailing Address
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Address Line | 800 S BEACH BLVD
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City | LA HABRA
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State | CA
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Zip | 90631-6484
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Country | US
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Telephone | 323-409-1000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95022129
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License Number State | CA
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